Drowning

Drowning is defined as respiratory impairment from being in or under a liquid. It is further classified by outcome into: death, ongoing health problems and no ongoing health problems. Using the term neardrowning to refer to those who survive is no longer recommended.

• Drowning is the 3rd leading cause of unintentional injury death worldwide, accounting for 7% of all injury-related deaths.
• There are an estimated 372 000 annual drowning deaths worldwide.
• Global estimates may significantly underestimate the actual public health problem related to drowning.
• Children, males and individuals with increased access to water are most at risk of drowning.

Gender

Males are especially at risk of drowning, with twice the overall mortality rate of females. They are more likely to be hospitalized than females for non-fatal drowning. Studies suggest that the higher drowning rates among males are due to increased exposure to water and riskier behaviour such as swimming alone, drinking alcohol before swimming alone and boating.

Access to water

Increased access to water is another risk factor for drowning. Individuals with occupations such as commercial fishing or fishing for subsistence, using small boats in low-income countries are more prone to drowning. Children who live near open water sources, such as ditches, ponds, irrigation channels, or pools are especially at risk.

Flood disasters

Drowning accounts for 75% of deaths in flood disasters. Flood disasters are becoming more frequent and this trend is expected to continue. Drowning risks increase with floods particularly in low- and middle-income countries where people live in flood prone areas and the ability to warn, evacuate, or protect communities from floods is weak or only just developing.

Travelling on water

Daily commuting and journeys made by migrants or asylum seekers often take place on overcrowded, unsafe vessels lacking safety equipment or are operated by personnel untrained in dealing with transport incidents or navigation. Personnel under the influence of alcohol or drugs are also a risk.

Other risk factors

There are other factors that are associated with an increased risk of drowning, such as:

• lower socioeconomic status, being a member of an ethnic minority, lack of higher education, and rural populations all tend to be associated, although this association can vary across countries;
• infants left unsupervised or alone with another child around water;
• alcohol use, near or in the water;
• medical conditions, such as epilepsy;
• tourists unfamiliar with local water risks and features;
• Someone is drowning

1. Get Help

• Notify a lifeguard, if one is close. If not, ask someone to call 911.
• If you are alone, follow the steps below.

2. Move the Person

• Take the person out of the water.

3. Check for Breathing

• Place your ear next to the person’s mouth and nose. Do you feel air on your cheek?
• Look to see if the person’s chest is moving.

4. If the Person is Not Breathing, Check Pulse

• Check the person’s pulse for 10 seconds.

5. If There is No Pulse, Start CPR

Carefully place person on back.

• For an adult or child, place the heel of one hand on the center of the chest at the nipple line. You can also push with one hand on top of the other. For an infant, place two fingers on the breastbone.
• For an adult or child, press down about 2 inches. Make sure not to press on ribs. For an infant, press down about 1 and 1/2 inches. Make sure not to press on the end of the breastbone.
• Do 30 chest compressions, at the rate of 100 per minute or more. Let the chest rise completely between pushes.
• Check to see if the person has started breathing.

Note that these instructions are not meant to replace CPR training. Classes are available through the American Red Cross, local hospitals, and other organizations.

6. Repeat if Person Is Still Not Breathing

• If you’ve been trained in CPR, you can now open the airway by tilting the head back and lifting the chin.
• Pinch the nose of the victim closed. Take a normal breath, cover the victim’s mouth with yours to create an airtight seal, and then give 2 one-second breaths as you watch for the chest to rise.
• Give 2 breaths followed by 30 chest compressions.
• Continue this cycle of 30 compressions and 2 breaths until the person starts breathing or emergency help arrives.
• Among the good things about residential swimming pools is the fact that so much research has been done on pool safety. One outgrowth of that research has been the development of a vast number of products and devices that aim to keep your pool safe.
• There are fences designed with self-closing, self-locking gates and rigid covers that slide over the pool like horizontal garage doors. There are even several electronic alarms of various designs. One is worn on the child’s wrist like a watch and sounds upon contact with water. Others sound an alarm when movement in pool water is detected.
• “Nothing is foolproof when it comes to protecting children from drowning in a pool,” says Mark Ross, a spokesman for the Consumer Product Safety Commission (CPSC). “That’s why we recommend that pool owners provide layers of protection.”
• Children between the ages of 1 and 4 are most at risk for fatal and nonfatal drowning, according to the CDC, which tracks drowning deaths. CDC data show that in children most drownings occur in residential swimming pools. In adults, most drownings occur in natural waters.
• But the majority of child drownings occur when children get into the pool on their own. The CDC found that “most young children who drowned in pools were last seen in the home, had been out of sight less than five minutes, and were in the care of one or both parents at home at the time.”

‘Layers’ of Pool Protection

The first and most important layer is constant, adult supervision during swim times. Other protective measures are important, too, says Ross. Here are some of their recommendations based on extensive product testing:

• The pool should be surrounded by a fence at least 4 feet tall.

The fence should have self-closing and self-latching gates with latches that are out of the reach of children. Teach Your Child to Swim

Teaching a child to swim would seem to add a further layer of drowning protection. But there is no evidence that swimming ability reduces a child’s chance of drowning. In fact, many of the drowned children in the CDC statistics knew how to swim.

“Learning to swim at the earliest reasonable age is a good idea,” said Brewster, of the Lifesaving Association. “But kids who drown are often under 4 years old, and even if they can swim,” they aren’t strong enough to get themselves up and out of the pool in time.

Brewster adds that if you have a pool, “you should have a rule that the child wears a Coast Guard-approved life jacket whenever the pool is being used.”

In addition, he advises that you hire a lifeguard whenever you have a pool party.

“Maintaining safety for swimmers and non-swimmers requires constant vigilance, and there is just too much going on at a party for any of the participants to provide that.”

The fence should completely separate the pool from the house. Deal with water hazards

The following recommendations can help you protect your child from drowning hazards:¹

• Don’t leave babies and young children alone in the bathtub or aswimming or wading pool. If a baby slips or rolls and lands facedown, he or she may not be able to turn over. Bathing seats or flotation devices may be used, but they don’t protect against drowning and aren’t a substitute for your attention.
• Don’t leave babies and young children alone around filled buckets, such as 5-gallon buckets used for cleaning. Empty buckets after each use, and keep them out of children’s reach. Buckets have tall, straight sides, which make it very hard for infants and young children to escape if they have fallen in.
• Leave toilet lids down. Keep young children out of the bathroom without your direct supervision. Make sure your toddler knows that the toilet isn’t a toy. Toilets are drowning hazards, especially for children younger than 3. An older baby or young child can fall headfirst into the water and not be able to climb back out. Consider placing a latch on the bathroom door, out of reach of young children.
• Empty all liquid containers immediately after use. Keep all empty containers out of reach of young children and babies. Don’t leave empty containers in the yard or around the house. They can accumulate water and become a drowning hazard.
• Empty coolers immediately after use, and keep lids closed. Store out of children’s reach.
• Watch children closely outdoors, especially where wells, open postholes, and irrigation or drainage ditches are nearby. Fill holes and install fences or other barriers to protect your child. Make sure pools are fenced off and have covers that lock. Don’t let a child out of your sight while you are doing yard work or other outdoor activities.
• Never let your child swim in any fast-moving water.

Prevention

There are many actions to prevent drowning. Installing barriers (e.g. covering wells, using doorway barriers and playpens, fencing swimming pools etc.) to control access to water hazards, or removing water hazards entirely greatly reduces water hazard exposure and risk.

Community-based, supervised child care for pre-school children can reduce drowning risk and has other proven health benefits. Teaching school-age children basic swimming, water safety and safe rescue skills is another approach. But these efforts must be undertaken with an emphasis on safety, and an overall risk management that includes a safety-tested curricula, a safe training area, screening and student selection, and student-instructor ratios established for safety.

Effective policies and legislation are also important for drowning prevention. Setting and enforcing safe boating, shipping and ferry regulations is an important part of improving safety on the water and preventing drowning. Building resilience to flooding and managing flood risks through better disaster preparedness planning, land use planning, and early warning systems can prevent drowning during flood disasters.

Developing a national water safety strategy can raise awareness of safety around water, build consensus around solutions, provide strategic direction and a framework to guide multisectoral action and allow for monitoring and evaluation of efforts.

When you’re outdoors in the water, wear a broad-spectrum, water-resistant sunscreen. You should apply at least 1 ounce — enough to fill a shot glass — over your whole body, including your feet, nose, ears, and lips. Don’t wait until you get to the beach or pool. Apply it 30 minutes before going outside. The higher the SPF on broad-spectrum sunscreens — up to SPF 50 — the better they protect against UVA and UVB rays. Reapply every two hours.

Teach swimming safety

Children need to learn to swim. You can help prevent drowning incidents by teaching your children basic safety rules and swimmingskills.

The following are suggestions to help you prepare your child for water-related activities:

• Teach your children four key swimming rules:²
• Always swim with a buddy.
• Don’t dive into unknown bodies of water. Jump feet first.
• Don’t push or jump on others while in the water.
• Be prepared for an emergency. Instruct children on getting help from an adult or calling 911.

                Don’t let your child use inflatable swimming aids (such as “water wings”) without constant supervision. They can deflate, or a child can slip out of them. Also, children can develop habits using these devices that can put them at risk for drowning. For example, a child who frequently uses water wings may learn to jump into a pool on impulse. He or she may do so while not wearing the devices, before having a chance to think about it.

                As a parent, learn to swim if you don’t already know how. Also, learn swimming survival and rescue techniques.

                If you enroll your child in swim lessons, remember that swim lessons won’t necessarily prevent drowning. Swim lessons may give you and your child a false sense of security and make you both less cautious around water. Be sure that your child swims only when a watchful adult is present.³

                When visiting public or private pools, make sure that your children are supervised closely and that they  .

Prevention

There are many actions to prevent drowning. Installing barriers (e.g. covering wells, using doorway barriers and playpens, fencing swimming pools etc.) to control access to water hazards, or removing water hazards entirely greatly reduces water hazard exposure and risk.

Community-based, supervised child care for pre-school children can reduce drowning risk and has other proven health benefits. Teaching school-age children basic swimming, water safety and safe rescue skills is another approach. But these efforts must be undertaken with an emphasis on safety, and an overall risk management that includes a safety-tested curricula, a safe training area, screening and student selection, and student-instructor ratios established for safety.

Effective policies and legislation are also important for drowning prevention. Setting and enforcing safe boating, shipping and ferry regulations is an important part of improving safety on the water and preventing drowning. Building resilience to flooding and managing flood risks through better disaster preparedness planning, land use planning, and early warning systems can prevent drowning during flood disasters.

Developing a national water safety strategy can raise awareness of safety around water, build consensus around solutions, provide strategic direction and a framework to guide multisectoral action and allow for monitoring and evaluation of efforts.

When you’re outdoors in the water, wear a broad-spectrum, water-resistant sunscreen. You should apply at least 1 ounce — enough to fill a shot glass — over your whole body, including your feet, nose, ears, and lips. Don’t wait until you get to the beach or pool. Apply it 30 minutes before going outside. The higher the SPF on broad-spectrum sunscreens — up to SPF 50 — the better they protect against UVA and UVB rays. Reapply every two hours.

Teach swimming safety

Children need to learn to swim. You can help prevent drowning incidents by teaching your children basic safety rules and swimmingskills.

The following are suggestions to help you prepare your child for water-related activities:

• Teach your children four key swimming rules:²
• Always swim with a buddy.
• Don’t dive into unknown bodies of water. Jump feet first.
• Don’t push or jump on others while in the water.
• Be prepared for an emergency. Instruct children on getting help from an adult or calling 911.

                Don’t let your child use inflatable swimming aids (such as “water wings”) without constant supervision. They can deflate, or a child can slip out of them. Also, children can develop habits using these devices that can put them at risk for drowning. For example, a child who frequently uses water wings may learn to jump into a pool on impulse. He or she may do so while not wearing the devices, before having a chance to think about it.

                As a parent, learn to swim if you don’t already know how. Also, learn swimming survival and rescue techniques.

                If you enroll your child in swim lessons, remember that swim lessons won’t necessarily prevent drowning. Swim lessons may give you and your child a false sense of security and make you both less cautious around water. Be sure that your child swims only when a watchful adult is present.³

                When visiting public or private pools, make sure that your children are supervised closely and that they  .